Manorcare Health Services - Fort Worth Nursing Home
General Information
UPDATEFederal Provider Number
455457
Provider Name
MANORCARE HEALTH SERVICES
Provider Address
2129 SKYLINE DR
FORT WORTH, TX 76114
FORT WORTH, TX 76114
Provider Phone Number
(817) 626-1956
Provider SSA County
910
Provider County Name
Tarrant
Provider Website
Provider Description
Ownership Type
For profit - Corporation
Number of Certified Beds
104
Number of Residents in Certified Beds
91
Provider Type
Medicare and Medicaid
Provider Resides in Hospital
N
Legal Business Name
MANOR CARE OF FORT WORTH TX (NW) LLC
Date First Approved to Provide Medicare and Medicaid services
1980-02-01
Continuing Care Retirement Community
N
Special Focus Facility
N
Provider Changed Ownership in Last 12 Months
N
With a Resident and Family Council
Resident
Automatic Sprinkler Systems in All Required Areas
Yes
Rating Detail Information
Overall Rating
4
Overall Rating Footnote
Health Inspection Rating
4
Health Inspection Rating Footnote
QM Rating
4
QM Rating Footnote
Staffing Rating
2
Staffing Rating Footnote
RN Staffing Rating
3
RN Staffing Rating Footnote
Reported Staffing Footnote
Physical Therapist Staffing Footnote
Reported CNA Staffing Hours per Resident per Day
1.79396
Reported LPN Staffing Hours per Resident per Day
0.68956
Reported RN Staffing Hours per Resident per Day
0.67527
Reported Licensed Staffing Hours per Resident per Day
1.36484
Reported Total Nurse Staffing Hours per Resident per Day
3.15879
Reported Physical Therapist Staffing Hours per Resident Per Day
0.07253
Expected CNA Staffing Hours per Resident per Day
2.43873
Expected LPN Staffing Hours per Resident per Day
0.68766
Expected RN Staffing Hours per Resident per Day
1.12872
Expected Total Nurse Staffing Hours per Resident per Day
4.25511
Adjusted CNA Staffing Hours per Resident per Day
1.80497
Adjusted LPN Staffing Hours per Resident per Day
0.83230
Adjusted RN Staffing Hours per Resident per Day
0.44702
Adjusted Total Nurse Staffing Hours per Resident per Day
2.99235
Cycle 1 Total Number of Health Deficiencies
1
Cycle 1 Number of Standard Health Deficiencies
1
Cycle 1 Number of Complaint Health Deficiencies
0
Cycle 1 Health Deficiency Score
16
Cycle 1 Standard Survey Health Date
2015-03-06
Cycle 1 Number of Health Revisits
1
Cycle 1 Health Revisit Score
0
Cycle 1 Total Health Score
16
Cycle 2 Total Number of Health Deficiencies
5
Cycle 2 Number of Standard Health Deficiencies
5
Cycle 2 Number of Complaint Health Deficiencies
0
Cycle 2 Health Deficiency Score
48
Cycle 2 Standard Health Survey Date
2014-03-13
Cycle 2 Number of Health Revisits
1
Cycle 2 Health Revisit Score
0
Cycle 2 Total Health Score
48
Cycle 3 Total Number of Health Deficiencies
0
Cycle 3 Number of Standard Health Deficiencies
0
Cycle 3 Number of Complaint Health Deficiencies
0
Cycle 3 Health Deficiency Score
0
Cycle 3 Standard Health Survey Date
2013-01-04
Cycle 3 Number of Health Revisits
0
Cycle 3 Health Revisit Score
0
Cycle 3 Total Health Score
0
Total Weighted Health Survey Score
24.00000
Number of Facility Reported Incidents
0
Number of Substantiated Complaints
0
Number of Fines
1
Total Amount of Fines in Dollars
1750
Number of Payment Denials
0
Total Number of Penalties
1
Location
Processing Date
2015-06-01
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